Burgess in the News

BioWorld: Medicare imaging stakeholders urge waiver of budget neutrality for MPFS

The Medical Imaging & Technology Alliance (MITA) and several other stakeholders in the Medicare imaging space penned a letter to congressional leaders urging them to intercede in proposed cuts to Medicare rates paid for medical imaging procedures. The signers of the letter, a group that also includes the American College of Radiology, stated that the 2020 Medicare physician fee schedule (MPFS) already encoded an adjustment for fees for evaluation and management (E/M) services that reduced rates for some services due to the budget neutrality requirement, which intersected with the COVID-19 pandemic to significantly reduce physician practice revenues by as much as 55%. The authors said the cuts that would ensue under the draft MPFS for calendar 2021 would force office closures, layoffs, suspended research programs, as well as delay equipment purchases. They urged Congress to waive the budget neutrality mandate for payment changes for the 2021 MPFS, adding that H.R. 8505, penned by Rep. Michael Burgess (R-Texas), is one possible legislative solution. The bill enjoys the support of three co-sponsors in addition to Burgess.

OIG: Medicare overpaid for facet-joint injections

The Office of Inspector General (OIG) at the U.S. Department of Health and Human Services reported that Medicare administrative contractors (MACs) that had instituted coverage limitations in 11 jurisdictions for facet-joint injections had overpaid for those services by nearly $749,000 between Jan. 1, 2017, and May 31, 2019. OIG said that had such policies been in place in the remaining jurisdictions, Medicare savings could have been as high as $513,000, adding that oversight by the Centers for Medicare & Medicaid Services (CMS) is not adequate to detect or suppress these improper payments. The report urged the CMS to recover the identified overpayments and to reimplement the coverage limitations in the remaining MAC jurisdictions.

FDA posts IIE policy for non-COVID tests

The U.S. FDA posted an immediately in effect (IIE) policy for modifications to FDA-cleared multi-analyte molecular tests for influenza viruses, including those for detection of respiratory syncytial viruses. The agency made note of the symptomatic overlap between COVID-19 and these other respiratory illnesses, as well as the commonality in testing equipment and supplies. It said the new policy would allow the use of a broader range of collection devices, and transport media may alleviate some of the pressure applied to the supply chain by the pandemic. Among the permitted modifications that do not require premarket notification for the duration of the public health emergency is a change to labels for the addition of sterile phosphate-buffered saline as an additional transport medium when viral transport media were required. Another change is to permit the use of non-nasopharyngeal swabs, such as swabs of the nares or mid-turbinates, with associated label changes. However, any other sample sources and transport media are not included in the scope of the IIE guidance, the agency said.


Published here.